Day 4, Final Day of General Surgery - Sean

My last day of early morning rounds in the surgery ward was today. Again the usual routine of patient status updates took place. Today the magic number was 22 again...22 patients. It still amazes me to watch Dr. Yu and his residents put their brains on rapid fire and efficiently work through their patient queue. Once everything was finished, Dr. Yu thought it would be a good idea for me to join one of his colleagues, the former dean of the hospital and fellow surgeon, Dr. Chen on his clinic duty.

I was shocked after only the first hour! More than half of the patients were women diagnosed with breast carcinomas. Most of these women underwent surgeries to have either partial or complete mastectomies. I was completely lost most of the time, unsure of what to do while Dr. Chen and an intern performed follow-up physical exams on these patients. Luckily for me, the intern (actually a 7th year medical student in Taiwan, equivalent to a 4th year medical student in the U.S.) spoke English extremely well and so she explained a lot of what was going on to me. Dr. Chen was also very capable of explaining things in English, and did so when he thought appropriate.

All I can say is I'm thankful I wasn't the intern, because she was getting pimped left and right. It was impressive how she knew most of the answers, but wow was Dr. Chen aggressive. "What is the mechanism of cyclophosphamide...5-fluoro-uracil...methotrexate? Name their side effects." I was somewhat familiar with these drugs having learned about a few of them, but I was in no shape to answer such specific questions at the drop of a hat. You could tell his intentions were to teach and that he wanted you to learn, so it was not as scary as it may sound.

After 3 three hours in the clinic, there were a couple things that stood out to me. It was a bit difficult to witness a patient and her family receive bad news about her lab results. The report showed she had a breast carcinoma that would require a complete mastectomy. Talk about breaking bad news. It's entirely different than the TBL mock session we had at Touro. You could feel the sadness and confusion in the room. I admire the courage of the physician that broke the news to the family. It must not have been easy. The other thing that I remember clearly is seeing the sense of relief of a women that had come in because she found a lump in her breast. It turns out that she already had a mastectomy of one of her breasts, and had also recently completed her regime of chemotherapy. Once Dr. Chen examined the lump and told her it was nothing to worry about, I could almost feel the tension and worry disappear from her face.

In the afternoon, I saw a mastectomy and one last partial hepatectomy for the week. This time, the hepatectomy was part of a joint surgical procedure because the patient also had rectal cancer. The first surgical team removed the rectal cancer, and then Dr. Yu's team came to perform the hepatectomy. Before I left that final surgery, Dr. Yu welcomed me to come join him in the OR anytime I am free in the later weeks. I'm sure that my schedule will be busy in the other departments, but if I ever do find time, I think I would like to check out more surgeries. It's just a fascinating world--the world of surgery.

Again, I can't believe that my first week is over already. General Surgery is awesome. Although I had to wake up early most of the week, it was well worth the experiences. The opportunity to see what it takes to be a surgeon was definitely eye-opening. It is clearer to me now more than ever that choosing a specialty should based on something I have a passion for. Dr. Yu's hectic schedule is almost maddening, but it was obvious that he enjoys what he does from the way he interacts with patients. I have learned much from him, and hope that my ventures into other specialties will be as enlightening as it was in General Surgery.